Medicare’s hospital audit regime

Medicare paid hospitals more than $180 billion in 2016, and the feds continue to conduct aggressive audits that claw back money based on inappropriate billing, Axios’ Bob Herman reports.

The latest target: the University of Michigan Health System. HHS’ inspector general says UMHS has to forfeit $6.2 million after it found erroneous billing patterns with the system’s inpatient rehab claims, among other medical claims. UMHS disagreed with portions of the federal audit.

Other hospital systems have been hit with even bigger clawbacks:

Mount Sinai Hospital in New York City: $42 million, one of the largest-ever overpayments in an audit.

Bottom line: Hospitals hate the audits, arguing they are already subjected to similar payment reviews. But watchdog groups say hospitals need this kind of pressure to fix the industry’s poor track record of billing schemes, which Bob reported on previously.